Rwanda’s healthcare sector witnessed a significant transformation in eye care services following the introduction of Performance-Based Financing (PBF) in 2019, according to a recent study. The initiative has enhanced access and utilization of eye care at primary care levels, marking a pivotal shift in the nation’s approach to healthcare delivery.
Increased Service Utilization
Before implementing PBF, Rwanda saw a decline in eye care consultations during the fiscal years 2018-2019. However, post-adoption of PBF, there was a remarkable surge in the number of patients seeking eye surgeries, escalating from 228,302 to over one million by the fiscal year 2021-2022. Additionally, the proportion of eye care patients in outpatient departments rose from 1.4% in 2017 to 5.4% in 2022, indicating a growing demand and improved accessibility.
Financial Sustainability Challenges
While the PBF model has successfully increased service utilization, it has also highlighted financial sustainability concerns. Donor contributions previously dominated the funding landscape, covering 64.2% of eye care expenses, including full funding for PBF. Recently, the Rwandan government has stepped up, raising its financial support from 28% in 2017 to 35.8% in 2022, ensuring sustainable salaries for eye care providers and maintaining essential infrastructure.
Inference insights include:
- Performance-Based Financing significantly boosts patient numbers in eye care services.
- Government funding increases are crucial for long-term sustainability of PBF initiatives.
- Despite improvements, provider shortages remain a barrier to comprehensive cataract treatment.
- Enhanced training and resource allocation are necessary to meet the growing demand.
The study underscores that while PBF has positively influenced the accessibility and utilization of eye care services in Rwanda, it also brings to light persistent challenges such as financial sustainability and workforce shortages. These issues necessitate ongoing attention from policymakers and development partners to ensure the continued success and expansion of PBF programs.
Rwanda’s proactive measures in increasing governmental support demonstrate a commitment to sustaining eye care improvements. For other low- and middle-income countries considering similar models, Rwanda’s experience offers valuable lessons on balancing donor reliance with national financial strategies. Strengthening healthcare systems through such financing models can lead to substantial gains in public health outcomes, provided that financial and human resource challenges are adequately addressed.
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